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phenelzine -MAOI
Anxiety/Depression/Bipolar
Term | Definition |
---|---|
phenelzine Route | PO well absorbed & widely distributed - mood elevation may take 2-8 weeks - metabolized in liver and excreted by kidneys |
phenelzine Action | Binds irreversibly to MAO increasing concentrations of epinephrine, norepinephrine, serotonin and dopamine in CNS |
phenelzine Use | Depression when other antidepressants have been unsuccessful in symptom management - rarely used now d/t specific artery dietary regimen required to prevent toxicity |
phenelzine Adverse effects | hypertensive crisis - can be precipitated by foods containing tyramine, dysrhythmias, drowsiness, dizziness, sexual dysfunction, orthostatic hypotension |
phenelzine contraindications | pheochromocytoma (tumor of adrenal gland), renal/hepatic impairment,should not have surgery requiring general anesthesia or spinal vasoconstrictors, pts who take other MAOI/weight reduction/ OTC cold or hay fever preparations containing vasoconstrictors |
phenelzine RN Considerations | take 3x/day PO - a reminder system may be helpful - med may be crushed and mixed w/ fluids or food for pts w/ difficulty swallowing.If patient eats any foods containing tyramine, hypertensive crisis may occur ■ Treatment = phentolamine |
tyramine containing foods | aged cheese, red wine, beer, fruits, chocolate, fruits, yogurt, sour cream, soy sauce |
What does tyramine do? | Normally large amounts of tyramine don’t reach systemic circulation, when deactivation is blocked by MAOI, tyramine is absorbed systemically which cause causes sudden release of large amounts of norepinephrine |